Most of the time, the actions of the United States Supreme Court don't seem to have a direct effect on everyday citizens. Many of the issues the high court deals with involve individual cases such as death penalty appeals or lawsuits. While those rulings set legal precedent and change the way laws are interpreted, they often go unnoticed outside the legal profession. But that wasn't the case with a ruling the U.S. Supreme Court handed down last week. That decision involved an issue that touches every one of us, but especially affects seniors: prescription drug prices.
The Supreme Court ruled that a state can try to force companies to lower prescription drug prices for the poor and uninsured. The 6-3 decision was in response to a battle between prescription drug companies and the Maine state government, which is poised to enact a program that could lower prices by 25 percent and help more than 300,000 residents. While court didn't endorse Maine's program, the justices said that drug makers did not make a sufficient case for blocking it.
National reports have noted that drug prices have risen by double-digit percentages each year. West Virginia's Public Employees Insurance Agency estimates that prescription drug costs will nearly triple over the next four years - a 23 percent increase each year. Gov. Bob Wise has said that prescription drugs cost Medicaid more than it costs the program to pay for 10,000 West Virginians to stay in nursing homes.
Much like Maine, West Virginia hasn't taken the situation sitting down. The state has initiated several steps ever since a task force was appointed in 2001 to study ways to reduce prescription drug costs.
In November, the state began participating in a multi-state prescription purchasing pool for programs such as PEIA, Medicaid and the Children's Health Insurance Agency. The collaborative purchasing effort, called the Multi-State Pharmacy Work Group, was developed by Gov. Wise to try to lower costs by banding states together and increasing their purchasing volume. In other words, they buy in bulk.
PEIA has reported it is saving about $1 million a month through the purchasing pool, while it's estimated that the Children's Health Insurance Program will save about $3 million over the next three years.
The state also works to obtain drug discounts through the Golden Mountaineer Card. So far, the state Bureau for Senior Services has been able to obtain an average 18 percent discount on prescription drug purchases through the card, but most of those discounts have been provided by pharmacies, not drug manufacturers.
Medicaid also has a preferred drug list for recipients, which has resulted in additional savings. Some patient advocates have questioned whether Medicaid's preferred drug list overrides doctors' authority in choosing their patients' medication. Such issues should be closely monitored.
The Maine Rx Program would use that state's buying power under Medicaid to negotiate bulk discounts to help the working poor, retirees and others who lack health benefits. If the prices are not lowered during the next three years, the state could impose price controls. Drug manufacturers argue that the program is unconstitutional. Maine officials maintain that by forcing drug companies to bargain, the state is simply doing what other countries, such as Canada, do for all their citizens.
Regardless, West Virginia officials are hoping that the court's decision will make drug companies more likely to negotiate with other states.
I welcome and appreciate your input on these issues, or any other legislative matter. Please call me at (304)340-3106 or write to Delegate Virginia Mahan, 215-E, Capitol Complex, Charleston, WV 25305.